tbuckley/cabot-search huggingface dataset:
AB0864 IDIOPATHIC INFLAMMATORY MYOPATHIES AND CANCER RISK STRATIFICATION
Authors: A. Hočevar, M. Tomsic, K. Perdan-Pirkmajer
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with idiopathic inflammatory myopathies (IIMs) are at increased risk of cancer, particularly in the first ±3 years of the disease, and a cancer risk stratification was proposed recently <sup>[1]</sup>, to improve cancer screening in IIMs. <h3>Objectives</h3> The aim of our retrospective study was to determine the frequency, temporal relations, and cancer types, as well as to evaluate the performance of proposed cancer risk stratification tool in our well-defined IIM cohort. <h3>Methods</h3> We analyzed medical records of IIM patients diagnosed between January 2005 and December 2020 and followed at our rheumatology centre of a median (IQR) 72.6 (35.1; 126.9) months. The development of cancer, its location and temporal relationship to IIM diagnosis were extracted. We applied the proposed cancer risk stratification <sup>[1]</sup> in a cohort of our patients. <h3>Results</h3> In a cohort of 175 IIM patients (122 females, 69.7%), 38 patients (21.7%; 24 females (19.7%) and 14 males (26.4%)) developed 41 cancers. Fifteen cancers (39.5%) were diagnosed or were active/relapsing within the two years prior to diagnosis of IIM, 10 cancers (26.3%) were diagnosed concurrently with IIM, and 16 (39.0%) cancers were diagnosed during the IIM follow up (9 (22.0%) of them during the first 3 years of the follow up) (Figure 1, Panel A). The most frequently diagnosed cancers were breast and gynaecologic cancers in females (20.0% each), and urogenital cancers in men (43.8%). The cancer location (overall and sex stratified) is presented in Table 1. The Figure 1, panel B shows the stratification of patients to their estimated risk of developing cancer, and the actual proportion of patients who develop cancer. Based on the estimated risk, 6.3%, 46.3% and 47.4% IIM patients were allocated into low-, intermediate- and high-risk group, respectively. While there were no episodes of cancer from -2 years to +3 years of follow up in the low-risk group, 12.5% patients in the intermediate-risk group, and 31.3% in the high-risk group developed cancer during this time interval. <h3>Conclusion</h3> Cancer affected a fifth of our IIMs patients. Almost a third of patients who were at high risk of cancer had cancer associated myositis. <h3>Reference</h3> [1]Oldroyd AGS, et al. Rheumatology (Oxford) 2021. Doi: 10.1093/rheumatology/keab166 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1476 EVALUATION OF AUTOANTIBODIES POSITIVITY IN SARCOIDOSIS PATIENTS
Authors: B. Ruaro, P. Confalonieri, M. Confalonieri, F. Salton
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Several studies reported serum positivity for anti-nuclear (ANA), extractable nuclear antigen (ENA) and antiphospholipid antibodies in sarcoidosis patients [1,2]. However, their clinical significance is still a matter of debate. <h3>Objectives</h3> Several studies reported serum positivity for anti-nuclear (ANA), extractable nuclear antigen (ENA) and antiphospholipid antibodies in sarcoidosis patients [1,2]. However, their clinical significance is still a matter of debate. <h3>Methods</h3> We enrolled 260 sarcoidosis patients (170 females and 90 males; mean age at diagnosis 46 ± 9), after giving written informed consent. We perform clinical evaluations, laboratory tests and radiology features. <h3>Results</h3> 89 sarcoidosis patients were ANA positive (34%, titre ≥ 1:160), 34 patients presented ENA positivity (15%) and antiphospholipid antibodies were positive in 20 patients (8%). No statistical significant correlations were observed between ANA/ENA positivity and clinical, laboratories and imaging evaluations. However, there was a statistically significant increase of the presence of antiphospholipid antibodies in sarcoidosis patients with a diagnosis of pulmonary embolism (p-value 0.04). <h3>Conclusion</h3> This study demonstrated an increase of antiphospholipid antibodies positivity in sarcoidosis patients with pulmonary embolism. These results may support the screening for these antibodies in all sarcoidosis patients. Further studies are underway to confirm these preliminary data and to evaluate if the positivity of autoantibody in these patients might suggest autoimmune implications in the pathogenesis of sarcoidosis. <h3>Reference</h3> [1]Turetz M, et al. Semin Intervent Radiol 2018;35:92-98; 2. Larsson J, et al. Sarcoidosis Vasc Diffuse Lung Dis 2020; 37: 104-135; 3. Ruaro B, et al. J Clin Med. 2021;10:2462. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0888 CLINICAL CHARACTERISTICS OF ANTI HMGCOA REDUCTASE ANTIBODY POSITIVE IMMUNE MEDIATED NECROTIZING MYOPATHY: CASE SERIES OF 5 PATIENTS FROM A TERTIARY CENTRE
Authors: C. Rosa, K. Chaudhuri, T. Blake, T. Potter, S. Banerjee
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Immune Mediated Necrotizing Myopathy is a type of autoimmune myopathy which is commonly associated with the use of statins. Common antibody detected in these patients would be HMGCoA reductase antibodies. Significant muscle necrosis with paucity of cellular infiltration is the characteristic histological feature. <h3>Objectives</h3> To describe clinical and therapeutic characteristics of anti HMGCoA reductase antibody positive necrotizing myopathy. <h3>Methods</h3> Cohort of patients with myositis were selected. The myositis antibody panel was assessed and patients with HMGCoA reductase antibody were selected. Diagnosis was made based on the 2017 EULAR/ ACR criteria <sup>[1]</sup>. Clinical manifestations, statin use, investigations, treatment offered, and outcome were described. <h3>Results</h3> Of the selected 5 cases, all the patients were middle aged with 3 males and 2 female patients. All 5 patients were on statins and 3 of them were on statins for many years prior to development of myopathy. None of the cases had other systemic involvement including dermatological or cardiac involvement. All 5 patients were positive for HMGCOA reductase antibodies. One patient had CLL which never required any specific treatment and another was incidentally found to have an atypical lipoma which was managed conversatively. All patients required steroids with either Methotrexate and Mycophenolate mofetil. Three of the patients received intravenous immunoglobulin therapy with good response. All of the patients had made a complete recovery though 2 of them required prolonged rehabilitation. <h3>Conclusion</h3> Statin induced necrotising myopathy patients could develop the disease after many years of statin therapy. It is possible that changes in the drug or the dose could act as a precipitant. This cohort of patients tend to be treated with intravenous immunoglobulin in addition to other conventional treatments. In spite of having very severe disease at the onset, with timely and appropriate immunosuppression and rehabilitation patients appeared to have a good outcome. <h3>Reference</h3> [1]Lundberg IE, Tjärnlund A, Bottai M. 2017 EULAR/ ACR classification criteria for adult and juvenile idiopathic inflammatory myopathies and their major subgroups. <i>Ann Rheum Dis</i>. 2017;76(12):1955-1964. doi:10.1136/annrheumdis-2017-211468 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1202 PARTICULARITIES OF KNEE OSTEOARTHRITIS FUNCTIONAL IMPACT IN A GERIATRIC POPULATION
Authors: L. Rouached, W. Lahmar, S. Bouden, A. Ben Tekaya, I. Mahmoud, R. Tekaya, O. Saidane, L. Abdelmoula
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Knee osteoarthritis (KOA) is the most common of osteoarticular diseases. Its increasing incidence with age means that the geriatric population is particularly exposed. <h3>Objectives</h3> The aim was to study the functional impact of knee OA in elderly subjects. <h3>Methods</h3> A cross-sectional study of 52 patients aged ≥65 years, followed for knee OA. Clinical characteristics of knee OA, pain intensity (VAS) were collected. Functional impact was assessed by the short form of the Knee Injury and Osteoarthritis Outcome Score (KOOS-PS) with a score ranging from 0 (no difficulty) to 100 (extreme difficulty). Radiographic severity was classified according to the Kellgren Lawrence criteria. <h3>Results</h3> The mean age was 73.7±7.8 years and the sex ratio (male/female) was 0.13. KOA was femoro-tibial in 79% and femoro-patellar in 21%, the internal compartment was affected in 98% of cases, and a bilateral involvement was found in 94% of cases. The knees were in varus in 30% of cases, in valgus in 23%. The VAS pain was 6.63±1.89. The mean KOOS-PS score was 48.04±19.1. The radiographic severity stages of KOA according to KL were classified as follows: stage 2 (17%), stage 3 (50%), and stage 4 (33%). A positive and significant correlation between the KOOS and VAS pain was found (r: 0.6; p&lt;0.00). There was no correlation between the KOOS and the radiographic stage (p=0.17), the duration of evolution (p=0.43). <h3>Conclusion</h3> In elderly patients with knee OA, there is no concordance between radiographic severity and functional impact. The latter goes hand in hand with the pain experienced. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1338 CLINICAL COURSE IN COVID 19 DISEASE IN IMMUNOSUPRESSED PATIENTS DIAGNOSED WITH RHEUMATIC DISEASES
Authors: M. Migkos, E. Kaltsonoudis, T. Zoi, E. Pelechas, N. Kougkas, A. Garyfallos, P. Voulgari, A. Drosos
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with pre-existing rheumatic diseases may be exacerbated during SARS-CoV-2 infection, or may develop new autoimmune features. Furthermore, immunosuppressive agents used to treat autoimmunity-inflammation as well as comorbidities can also affect the disease outcome. <h3>Objectives</h3> To evaluate the outcome of rheumatic diseases after Covid 19 infection in patients diagnosed with rheumatic diseases, under various immunosuppressive treatment, as well as the effects of vaccines against Covid or antiviral treatment in this sensitive population group. <h3>Methods</h3> During the pandemic, 1493 patients with autoimmune or autoinflammatory disease who were continuously followed up in two tertiaries hospitals in northern and northwestern Greece were included in the current study. The patients were compared with 769 controls after adjustment for age, sex, weight, vaccination status and comorbidities. Of the 1493 patients, 648 had rheumatoid arthritis, 282 psoriatic arthritis, 173 ankylosing spondylitis, 122 systemic lupus erythematosus, 98 Sjogren's syndrome, 43 polymyalgia rheumatica, 34 mixed connective tissue disease or overlapping syndromes, 31 vasculitis, 27 systemic sclerosis, 18 myositis, 10 Behcet syndrome, 5 primary antiphospholipid syndrome and 2 had Familial Mediterranean Fever. The vast majority of patients and controls were fully vaccinated (82%) and 397 patients received antiviral treatment, 94% of them were fully vaccinated. <h3>Results</h3> Covid 19 disease in vaccinated patients with rheumatic diseases was shown to perform the same or about the same as those in the control group after adjustment for risk factors for severe disease. 19 of our patients required admission in the intensive care unit (62% full vaccinated) while a total of 12 died (66% non vaccinated). Major risk factors for severe disease were previous respiratory failure, chronic renal impairment, obesity, and failure to receive antiviral therapy. It was also shown that infection with Covid led to an exacerbation or induction of autoimmune disorders in 25 of the participants. <h3>Conclusion</h3> In this large cohort, Covid 19 disease was shown to affect patients with autoimmune rheumatic diseases the same or approximately the same way as the general population if they are fully vaccinated and if they start timely antiviral treatment where indicated. Further research and monitoring of the results after the multiple mutations of the virus is advisable. <h3>References</h3> None. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1412 THE DAMAGE OF JUVENILE IDIOPATHIC ARTHRITIS IN ADULT PATIENTS
Authors: K. Kern, D. Kaudewitz, H. M. Lorenz, J. P. Haas, N. Blank
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Juvenile idiopathic arthritis (JIA) is the most common disease in pediatric rheumatology. After transition, chronic active JIA requires continuing treatment. Little is yet known about the JIA activity in adult patients. <h3>Objectives</h3> To assess disease activity, treatment and comorbidities in adult patients with JIA between 2000 and 2022 at the University Hospital of Heidelberg. <h3>Methods</h3> This is a monocentric, retrospective analysis of adult patients with onset as JIA. The electronic medical records were analyzed from the first to the last documented visit in our center. Prognostic factors for disease activity in adults were determined using Fisher's exact test, chi-square test and cross tables. <h3>Results</h3> Until March 2022, 172 JIA patients with a median age of 27.7 years (range 18.1 to 78.4) and a median disease duration of 19.4 years (range 1.3 to 68.8) at their last visit were identified. Oligoarticular (oligo-) (n=36, 20.9%), extended-oligo (ext-oligo-) (n=28, 16.3%) and polyarticular (poly-) (n=61, 35.5%) were the largest JIA subgroups. Females (n=134, 77.9%) were more prevalent than males (n=38, 22.1%) (p&lt;0,001). The prevalence of uveitis was 27.9% (n=48). Patients with RF+ poly-JIA (n=17, p&lt;0,001) or initiation of MTX after 2 years (n=41, p=0,006) or bDMARD after 3 years (n=44, p&lt;0,001) of disease onset were associated with significantly more erosive joint damage. Patients with late MTX and/or bDMARD initiation (n=190) had more frequently osteoporosis (n=48, p=0,011, p=0,012) and required more frequently total joint replacement (n=41, p=0,012, p=0,04). Radiological joint damage was more prevalent in patients with a disease onset before the year 2000. At the last documented visit 51.8% of patients (n=72) were in SDAI and DAS28 remission. <h3>Conclusion</h3> The delay of MTX and bDMARD therapy in patients with active JIA was associated with erosive joint damage, total joint replacement and osteoporosis. The JIA onset before the year 2000 was associated with significantly more joint damage and a lower prevalence of remission. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB1200 WAIST CIRCUMFERENCE AND GONARTHROSIS
Authors: A. Rafi, F. Idrissi Zaki, Z. Baba, A. Mougui, I. El Bouchti
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Overweight, translated into a high body mass index (BMI), is associated with a risk of gonarthrosis, thus, this risk is increased by 15% for each increase of a unit of body mass index (BMI). (1) Various studies indicate that the association of high BMI and abdominal obesity measured by waist circumference leads to increased morbidity especially in obese. But no study has so far shown a sufficiently strong association force between waist circumference and gonarthrosis.(2,3) <h3>Objectives</h3> The objective of our study is to assess the relationship between waist circumference and pain perception and gonarthrosis impact. <h3>Methods</h3> This work included patients followed in consultation for gonarthrosis. For each patient we specified next to the demographic data, the BMI, the waist circumference, and the existence or no pain of the knee or both. The intensity of pain was assessed by the Analog Visual Scale (EVA). Functional impact was assessed by the Lequesne index and Womac score. Knee X-rays were classified according to Kellgren Lawrence (KL) criteria. <h3>Results</h3> A total of 209 patients were included (24 men/185 women). The average age was 57.94± 9.01 years. The average body mass index was 25.15 ±5.47 kg/m2and the average TI was 93.45 ±12.35 cm. The average pain EVA at rest was 1.95 2.53 and at stress 7.89 ±1.30. Womac's average score was 12.3± 8.92 and Lequesne's average index was 6.71 3.20. WOMAC SCORE was significantly higher in gonarthrosis patients with a high waist circumference (p = 0.02). A positive correlation was found between the resting and stress pain EVA and the waist circumference of gonarthrosic patients with respectively (p=0.04, p=0.002). but it is statistically insignificant between the radiographic stages, the lesquene index and waist circumference with (p=0.11, p=0.06, respectively). <h3>Conclusion</h3> The the waist circumference seems to be a predictive factor of the presence of gonalgie and a significant functional impact. <h3>References</h3> [1]L.Jiang, W.Tian, Y.Wang and col. Body mass index and susceptibility to osteoarthritis of the knee: meta-analysis. Rev Rhum Engl Ed 2012;2:142-148 [2]Canadian Joint Replacement Registry. Total Hip and Total Knee Repla- cements in Canada: 2005 Report. Ottawa, ON: Canadian Institute for Health Information; 2005. [3]Tjepkema M, Shields M. Measured Obesity: Adult Obesity in Canada. Catalogue No. 82–620-XWE2005001 ed. Ottawa: Statistics Canada; 2005. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.
AB0874 EPIDEMIOLOGY AND CLINICAL FEATURES OF IDIOPATHIC INFLAMMATORY MYOPATHIES IN SINGLE REGION IN NORTHERN SPAIN
Authors: C. Corrales-Selaya, D. Martínez-López, D. Prieto-Peña, J. L. Martín-Varillas, R. Blanco
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of disorders characterized by proximal muscle weakness and inflammation. The main subtypes of IIM are dermatomyositis (DM), polymyositis (PM), inclusion body myositis (IBM), immune-mediated necrotizing myopathy (IMNM) and antisynthetase syndrome (ASS). Prevalence and incidence vary depending on the geographic location. <h3>Objectives</h3> To describe the epidemiological and clinical features of IIM in a single region in northern Spain. <h3>Methods</h3> We included all consecutive patients diagnosed with IIM in the region of Cantabria, excluding IBM, from January 2000 to December 2022. IIM was diagnosed by expert rheumatologists according to <b>a</b>) EULAR/ACR 2017 classification criteria of IIM in PM and DM, <b>b</b>) Definition of the European Neuromuscular International Workshop 2016 in IMNM and <b>c</b>) Connor's criteria in ASS. Data regarding demographics features, clinical findings, laboratory tests and treatments were extracted from the patients' clinical records. <h3>Results</h3> We included a total of 63 patients, mean age at diagnosis 52.1±19.3 years. Most of the patients were women (n=44, 69.8%). Main features are shown in <b>TABLE 1</b>. Prevalence of IIM was 10.8/100.000 population. The incidence rate was 4.9 cases per million persons per year. An upward trend in annual incidence was observed from 1.7 in 2000 to 15.4 per million in 2018 <b>(FIGURE 1</b>). The most common IIM subtype was DM (n=34, 54%). Gottron papules, muscle weakness and Interstitial lung disease were the most frequent manifestations in DM, IMNM and ASS group, respectively. The most frequent autoantibody was anti-Ro 52 (n=12, 19%), however in 28 patients (44.4%) none was detected. Most used treatments were glucocorticoids (n=61, 96.8%), azathioprine (n=30, 47.6%), intravenous immunoglobulins (n=29, 46%) and rituximab (n=29, 46%). <h3>Conclusion</h3> We describe the prevalence, incidence rate, clinical features and main treatments used in IIM in our area. An upward trend in annual incidence was observed in our study. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Cristina Corrales-Selaya: None declared, David Martínez-López: None declared, Diana Prieto-Peña Grant/research support from: UCB Pharma, Roche, Sanofi, Pfizer, Jansen, Amgen, AbbVie, Novartis, and Lilly., José Luis Martín-Varillas Grant/research support from: AbbVie, Pfizer, Lilly, Celgene, Janssen, and UCB Pharma., Ricardo Blanco Speakers bureau: Abbvie, Pfizer, Roche, lilly, Bristol-Myers, Janssen, Galapagos and MSD., Consultant of: Abbvie, Pfizer, Roche, lilly, Bristol-Myers, Janssen and MSD., Grant/research support from: Abbvie, MSD, novartis and Roche.
AB1324 COVID-19 CHALLENGE IN THE ANTIPHOSPHOLIPID SYNDROME – AN OBSERVATIONAL STUDY OF A SERBIAN COHORT
Authors: A. Djokovic, L. Stojanovich, N. Stanisavljevic, S. Djokic, D. Colic, D. Škrijelj, I. Soldatovic, P. Matic
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Facing the outburst of the COVID-19 pandemic, we gradually comprehend its pathophysiology as a coagulopathy characterized by increased risks of arterial, venous, and microvascular thrombosis. Antiphospholipid syndrome (APS) is an autoimmune, thrombo-inflammatory disease characterized by thrombosis and/or pregnancy loss in the presence of one or more antiphospholipid antibodies (aPL). <h3>Objectives</h3> To evaluate the clinical scenario of COVID-19 in the APS population of patients. <h3>Methods</h3> This is a single-center, observational, cross-sectional study. Data regarding the severity of COVID-19 (severe COVID-19 considered if interstitial pneumonia was diagnosed), COVID-19 vaccinal status, and post-vaccinal reactions (divided into mild, consisting of fever, myalgia, nausea, and severe if thrombosis at any point occurred) were collected from 44 APS patients (21 with primary and 23 with APS associated with systemic lupus erythematosus (SLE), 90.1% female). aPL analysis included the detection of aCL (IgG/IgM), ß2GPI (IgG/IgM), and LA Results were compared to the control group consisting of 31 healthy individuals, with no APS, matched to the APS group regarding age and gender. <h3>Results</h3> At the moment of COVID-19 infection, 75% of the APS group was taking Aspirin, 15.9% warfarin, 2.3% non-vitamin K oral anticoagulant, 59.1% chloroquine, 31.8% corticosteroid, 2.3% methotrexate. None of the above-mentioned medications were taken from a control group. There was no difference regarding the severity of COVID-19 between APS patients and healthy controls: 84.1% of APS had mild and 15.9% severe COVID-19 (p=0.509, p=0.292 respectively). But the difference regarding the need for hospitalization was significant (none of the healthy controls compared to 11.4% APS patients, p=0.0073). Interestingly, COVID-19 occurred in 72.7% of APS patients before the COVID-19 vaccination compared to 35.5% of healthy controls, p=0.001, conversely, a significantly lower percentage of vaccinated APS patients had COVID-19 compared to healthy controls (34.1% to 71.0%, p=0.002). 27% of APS patients had mild post-vaccinal reactions, none with severe. <h3>Conclusion</h3> During the COVID-19 pandemic, APS patients in Serbia were at higher risk for hospitalization. However, there was no difference in the severity of clinical presentation compared to non -the APS population. We can only speculate that APS therapy consisting of Aspirin, Chloroquine, and oral anticoagulant therapy contributed to this finding. Moreover, COVID-19 vaccination in the APS population, followed by a low incidence of mild post-vaccinal reactions, had more benefits in protection than in non-APS individuals. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.